Literature DB >> 11040008

Natural and unnatural history of pulmonary atresia.

H Leonard1, G Derrick, J O'Sullivan, C Wren.   

Abstract

OBJECTIVE: To investigate mortality, cause of death, survival, and quality of life in all types of cardiac malformation with congenital pulmonary atresia.
DESIGN: Retrospective analysis.
SETTING: The resident population of one health region with a single tertiary referral centre. PATIENTS: All babies with pulmonary atresia live born in 1980 to 1995. MAIN OUTCOME MEASURES: Anatomical classification, total mortality, cause of death, duration of survival, exercise ability. All cases were classified as pulmonary atresia with intact septum (PA-IVS), pulmonary atresia with ventricular septal defect (PA-VSD), or pulmonary atresia with complex cardiac malformation (complex pulmonary atresia).
RESULTS: 129 cardiac malformations with congenital pulmonary atresia were identified from 601 635 live births (21.4/100 000): 29 had PA-IVS, 60 had PA-VSD, and 40 had complex pulmonary atresia. Total mortality was 72/129 (56%), with 15 deaths in the first week and 49 in the first year. There were 23 surgical deaths, 33 hospital deaths (not related to surgery), and 16 sudden deaths, 12 of which remained unexplained. The sudden death rate was 29/1000 patient years of follow up. Of the 57 survivors, 39% have exercise ability I or II and 61% III or IV. Definitive surgical repair produced better exercise ability.
CONCLUSIONS: Early mortality is high in all types of pulmonary atresia, although survival has improved in recent years. Most children who have not undergone definitive repair have significant exercise limitation.

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Mesh:

Year:  2000        PMID: 11040008      PMCID: PMC1729492          DOI: 10.1136/heart.84.5.499

Source DB:  PubMed          Journal:  Heart        ISSN: 1355-6037            Impact factor:   5.994


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Review 2.  Survival probabilities (the Kaplan-Meier method).

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Journal:  BMJ       Date:  1998-12-05

3.  Long-term results in neonates with pulmonary atresia and intact ventricular septum.

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4.  Analysis of survival in patients with pulmonic valve atresia and ventricular septal defect.

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5.  Presentation of congenital heart disease in infancy: implications for routine examination.

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6.  Temporal variability in birth prevalence of cardiovascular malformations.

Authors:  C Wren; S Richmond; L Donaldson
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7.  Pulmonary atresia with intact ventricular septum: impact of fetal echocardiography on incidence at birth and postnatal outcome. UK and Eire Collaborative Study of Pulmonary Atresia with Intact Ventricular Septum.

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8.  Outcomes in neonatal pulmonary atresia with intact ventricular septum. A multiinstitutional study.

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9.  Partial biventricular repair for complex congenital heart defects: an intermediate option for complicated anatomy or functionally borderline right complex heart.

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10.  Congenital heart disease: prevalence at livebirth. The Baltimore-Washington Infant Study.

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Review 6.  Comparison of staged repair versus single-stage complete repair for pulmonary atresia with ventricular septal defect: A systematic review and meta-analysis.

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7.  Prenatally diagnosed pulmonary atresia with ventricular septal defect: echocardiography, genetics, associated anomalies and outcome.

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10.  Rare de novo copy number variants in patients with congenital pulmonary atresia.

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